Changing Role in Employer Sponsored Health Care Using Data to Drive Health Improvement January 8, 2015 Agenda • • • • • Consider Population Demographics Consider Chronic Disease Prevalence Consider Utilization Patterns Consider Where You are Spending the Most Money Let the Data Drive Planning – Interventions – Supportive Health Coverage Demographics Example Plan Membership Males 1600 1400 Number of Members Consider Your Enrollment Profile: • % spouses • % employees • Males vs females Females 1200 1000 800 600 400 200 0 Employees Spouses Dependents Chronic Disease Burden Consider Rate of Chronic Disease • Rate for Employees • Rate for Spouses • Rate overall • How compares to norm Actual HMA Norm 60% 50% 40% 30% 20% 10% 0% Employees Spouses Dependents All Members Utilization Patterns High Intensity ER Visits* Number of Visits per 1000 Members Receipt of ER & Urgent Care • High vs low intensity • Rate of ER vs UC • Patterns over time Low Intensity ER Visits* 350 300 250 200 150 100 50 0 Emergency Room Emergency Room Urgent Care Urgent Care (current period) (previous period) (current period) (previous period) Utilization Patterns Office Visits / Member Wellness Visits / Member 7.0 Visits per Member per Year* Receipt of Office Visits & Preventive Care • Receipt of maintenance care • Males vs females • Employees vs spouses • Receipt of preventive care 6.0 5.0 4.0 HMA Norm Office Visits 3.0 2.0 Recommended Wellness Visits 1.0 0.0 Males Females Employees Spouses Chronic All Members Conditions Spending 36% of Medical Spending Medical Spending Per Member Per Year Spending Related to Chronic Disease • Proportion tied to those with chronic • Relationship between multiple chronic & cost Members without known Chronic Conditions 65% Members with Chronic Conditions 35% 64% of Medical Spending Actual HMA Norm $15,000 $10,000 $5,000 $0 One Two Three or More Number of Chronic Diseases My Information David Snodgrass President, CEO David.Snodgrass@accesstpa.com 425-289-5112 Check out HMA at: www.accesshma.com Thank you!